Contrasting presentations of the same disease: A comparison of two cases of amyloidosis presenting with eyelid involvement.

Purpose: Localized amyloidosis can affect numerous tissues throughout the body and can also affect a variety of peri-ocular tissues including the conjunctiva, extra-ocular muscles, peri-orbital soft tissue, and lacrimal gland. We report two cases of amyloidosis presenting with eyelid involvement. Observations: The first case represented a more subtle presentation of skin thickening with a pre-septal cellulitis, while the second case had a dramatic presentation of edema evolving into tissue dehiscence and spontaneous hemorrhage with ongoing angioedema and systemic coagulopathy. Conclusions and importance: The two cases of biopsy-proven orbital/peri-ocular amyloidosis demonstrate the different clinical presentations that may go from the subtle to dramatic, depending on which peri-ocular tissues are affected and to what degree. Standards for treatment of amyloidosis remain conservative initially with surgery or radiation recommended only for refractory cases, but additional therapies are under investigation. Clinicians should have high clinical suspicion for amyloidosis with findings such as skin thickening or significant periorbital edema and should always consider tissue biopsy and further workup for amyloidosis if the findings worsen or do not resolve with treatment of more common conditions such as cellulitis.

Psychosocial and Health Outcomes of Adults With Violently Acquired Pediatric Spinal Cord Injury.

Objective: To describe the psychosocial and medical outcomes of individuals with pediatric-onset spinal cord injury (SCI) as a result of violent injuries. Methods: This was a cross-sectional study assessing adult outcomes associated with pediatric-onset SCI. Participants completed measures assessing demographics, injury characteristics, secondary conditions, and psychosocial functioning. Results: Participants included 483 adults (ages 19-51 years; M = 32.89, SD = 6.81) who sustained an SCI prior to age 19 (0-18 years; M = 14.25, SD = 4.40). Participants tended to have complete injuries (68%) and tetraplegia (53%) and were predominantly male (63%) and Caucasian (85%). The violent (n = 42) and nonviolent (n = 441) etiology groups tended to be similar in terms of gender. The violent etiology (VE) group, however, was significantly more likely to have paraplegia (χ2 = 7.45, p = .01), identify as an ethnic minority (χ2 = 5.40, p = .02), and have decreased odds of completing a college degree (odds ratio [OR], 0.40; 95% CI, 0.19-0.83). After controlling for significant covariates, individuals in the VE group were more likely to have moderate depression symptoms (OR, 3.73; 95% CI, 1.35-10.30) and significantly lower odds of economic independence (OR, 0.39; 95% CI, 0.19-0.84). The VE group was also 2 times as likely as the nonviolent group to report a pressure injury (OR, 2.04; 95% CI, 1.05-3.94) or activity interfering pain (OR, 2.34; 95% CI, 1.15-4.74). Conclusion: The results of this study reveal significantly greater psychosocial health concerns and more medical complications for individuals with violent SCI than those with nonviolent SCI. Children with an SCI from a violent etiology may warrant additional attention and services aimed at promoting stability and long-term resilience.

Enhancing Teacher Beliefs through an Inquiry-Based Professional Development Program.

Inquiry-based instructional approaches are an effective means to actively engage students with science content and skills. This article examines the effects of an ongoing professional development program on middle and high school teachers' efficacy beliefs, confidence to teach research concepts and skills, and science content knowledge. Professional development activities included participation in a week long summer academy, designing and implementing inquiry-based lessons within the classroom, examining and reflecting upon practices, and documenting ways in which instruction was modified. Teacher beliefs were assessed at three time points, pre- post- and six months following the summer academy. Results indicate significant gains in reported teaching efficacy, confidence, and content knowledge from pre- to post-test. These gains were maintained at the six month follow-up. Findings across the three different time points suggest that participation in the professional development program strongly influenced participants' fundamental beliefs about their capacity to provide effective instruction in ways that are closely connected to the features of inquiry-based instruction.